[Autoimmune hepatitis : From autoantibodies to cirrhosis].
Autoimmune Hepatitis : Von Autoantikörpern bis Zirrhose.
Drug-induced liver injury
Immune system diseases
Immunosuppressive agents
Liver cirrhosis
Primary bile duct disease
Journal
Innere Medizin (Heidelberg, Germany)
ISSN: 2731-7099
Titre abrégé: Inn Med (Heidelb)
Pays: Germany
ID NLM: 9918384885306676
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
accepted:
12
04
2023
medline:
23
6
2023
pubmed:
12
6
2023
entrez:
12
6
2023
Statut:
ppublish
Résumé
Autoimmune Hepatitis (AIH) is an immune-mediated liver disease of unknown origin. Its clinical presentation is heterogeneous and ranges from asymptomatic courses over several years to acute forms with acute liver failure. Accordingly, the diagnosis is only made at the stage of cirrhosis in about one third of affected individuals. Early diagnosis and a consistent, adequate, individualized, immunosuppressive therapy are crucial for the prognosis, which is excellent when treated properly. AIH is rare in the general population and can be easily overlooked due to its variable clinical picture and sometimes difficult diagnosis. AIH should be considered as a differential diagnosis in any unclear acute or chronic hepatopathy. The therapy initially consists of remission induction and subsequently maintenance therapy with (often lifelong) immunosuppressants. Die autoimmune Hepatitis (AIH) ist eine immunvermittelte Lebererkrankung ungeklärter Genese. Klinisch präsentiert sie sich sehr heterogen: asymptomatische Verläufe über mehrere Jahre kommen ebenso vor wie akute Formen mit akutem Leberversagen. Entsprechend wird die Diagnose bei etwa einem Drittel der Betroffenen erst im Stadium der Zirrhose gestellt. Eine frühzeitige Diagnosestellung und eine konsequente, adäquate, individualisierte, immunsuppressive Therapie sind entscheidend für die Prognose, die bei guter Behandlung exzellent ist. Die AIH ist, auf die Gesamtbevölkerung bezogen, selten und wird aufgrund ihres variablen klinischen Bilds und der mitunter schwierigen Diagnosesicherung leicht übersehen. Eine AIH sollte bei jeder unklaren akuten oder chronischen Hepatopathie differenzialdiagnostisch erwogen werden. Die Therapie besteht initial in einer Remissionsinduktion und im Verlauf in einer Erhaltungstherapie mithilfe von Immunsuppressiva, Letztere meist lebenslang.
Autres résumés
Type: Publisher
(ger)
Die autoimmune Hepatitis (AIH) ist eine immunvermittelte Lebererkrankung ungeklärter Genese. Klinisch präsentiert sie sich sehr heterogen: asymptomatische Verläufe über mehrere Jahre kommen ebenso vor wie akute Formen mit akutem Leberversagen. Entsprechend wird die Diagnose bei etwa einem Drittel der Betroffenen erst im Stadium der Zirrhose gestellt. Eine frühzeitige Diagnosestellung und eine konsequente, adäquate, individualisierte, immunsuppressive Therapie sind entscheidend für die Prognose, die bei guter Behandlung exzellent ist. Die AIH ist, auf die Gesamtbevölkerung bezogen, selten und wird aufgrund ihres variablen klinischen Bilds und der mitunter schwierigen Diagnosesicherung leicht übersehen. Eine AIH sollte bei jeder unklaren akuten oder chronischen Hepatopathie differenzialdiagnostisch erwogen werden. Die Therapie besteht initial in einer Remissionsinduktion und im Verlauf in einer Erhaltungstherapie mithilfe von Immunsuppressiva, Letztere meist lebenslang.
Identifiants
pubmed: 37306752
doi: 10.1007/s00108-023-01519-9
pii: 10.1007/s00108-023-01519-9
doi:
Substances chimiques
Autoantibodies
0
Immunosuppressive Agents
0
Types de publication
English Abstract
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
655-667Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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